A system and method for monitoring air flow from a person

ABSTRACT

Monitoring airflow from a person is accomplished by using a central server arranged to receive and communicate data together with at least one microprocessor-based subsystem. The subsystem includes a microprocessor, a display and a memory. It presents information to the person on the display and processes a digital signal representing airflow from the person. Airflow-related data is communicated to the central server and, in turn, is communicated to at least one health care professional computer. The system can be used to realize systems for self-care monitoring and control of afflictions and physical conditions, such as chronic respiratory afflictions. The system can also be used together with other monitoring devices, such as glucose, blood pressure, pulse and temperature monitors, to monitor the person&#39;s conition and to communicate related data to the central server.

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application is a Continuation of application Ser. No.09/237,194, filed on Jan. 26, 1999, which is a Continuation ofapplication Ser. No. 08/481,925, filed on Jun. 7, 1995, now U.S. Pat.No. 5,899,855, issued May 4, 1999, which is a FWC of application Ser.No. 08/233,397, filed on Apr. 26, 1994, now abandoned, which is aContinuation of application Ser. No. 07/977,323, filed on Nov. 11, 1992,now U.S. Pat. No. 5,307,263, issued on Apr. 26, 1994. This applicationis also related to U.S. Pat. No. 6,168,563 which is aContinuation-In-Part of the above-referenced U.S. Pat. No. 5,899,855,and a Continuation-In-Part of U.S. Pat. No. 5,997,476, which claims thepriority to Provisional Application Serial No. 60/041,746, filed Mar.28, 1997 and Provisional Application Serial No. 60/041,751, filed Mar.28, 1997. This application is also related to U.S. Pat. No. 5,897,493,which also claims priority to Provisional Application No. 60/041,751 and60/041,746 both filed Mar. 28, 1997. This application is also related toapplication Ser. No. 10/233,296, filed on Aug. 30, 2002; applicationSer. No. 09/665,242, filed on Mar. 28, 1997; application Ser. No.10/319,427, filed Dec. 12, 2002, and application Ser. No. 09/713,922,filed on Nov. 15, 2000.

BACKGROUND OF INVENTION

[0002] Controlling or curing conditions of ill health generally involvesboth establishing a therapeutic program and monitoring the progress ofthe afflicted person. Based on that progress, decisions can be made asto altering therapy to achieve a cure or maintain the affliction orcondition at a controlled level. Successfully treating certain healthconditions calls for rather frequent monitoring and a relatively highdegree of patient participation. For example, in order to establish andmaintain a regimen for successful diabetes care, a diabetic shouldmonitor his or her blood glucose level and record that information alongwith the date and time at which the monitoring took place. Since diet,exercise, and medication all affect blood glucose levels, a diabeticoften must record data relating to those items of information along withblood glucose level so that the diabetic may more closely monitor his orher condition and, in addition, can provide information of value to thehealthcare provider in determining both progress of the patient anddetecting any need to change the patient's therapy program.

[0003] Advances in the field of electronics over the past several yearshave brought about significant changes in medical diagnostic andmonitoring equipment, including arrangements for self-care monitoring ofvarious chronic conditions. With respect to the control and monitoringof diabetes, relatively inexpensive and relatively easy-to-use bloodglucose monitoring systems have become available that provide reliableinformation that allows a diabetic and his or her healthcareprofessional to establish, monitor and adjust a treatment plan (diet,exercise, and medication). More specifically, microprocessor-based bloodglucose monitoring systems are being marketed which sense the glucoselevel of a blood sample that is applied to a reagent-impregnated regionof a test strip that is inserted in the glucose monitor. When themonitoring sequence is complete, the blood glucose level is displayedby, for example, a liquid crystal display (LCD) unit.

[0004] Typically, currently available self-care blood glucose monitoringunits include a calendar/clock circuit and a memory circuit that allowsa number of blood glucose test results to be stored along with the dateand time at which the monitoring occurred. The stored test results(blood glucose level and associated time and date) can be sequentiallyrecalled for review by the blood glucose monitor user or a healthprofessional by sequentially actuating a push button or other controlprovided on the monitor. In some commercially available devices, theaverage of the blood glucose results that are stored in the monitor (orthe average of the results for a predetermined period of time, e.g.,fourteen days) also is displayed during the recall sequence. Further,some self-care blood glucose monitors allow the user to tag the testresult with an “event code” that can be used to organize the testresults into categories. For example, a user might use a specific eventcode to identify test results obtained at particular times of the day, adifferent event code to identify a blood glucose reading obtained aftera period of exercise, two additional event codes to identify bloodglucose readings taken during hypoglycemia symptoms and hyperglycemiasymptoms, etc. When event codes are provided and used, the event codetypically is displayed with each recalled blood glucose test result.

[0005] Microprocessor-based blood glucose monitoring systems haveadvantages other than the capability of obtaining reliable blood glucosetest results and storing a number of the results for later recall andreview. By using low power microprocessor and memory circuits andpowering the units with small, high capacity batteries (e.g., a singlealkaline battery), extremely compact and light designs have beenachieved that allow taking the blood glucose monitoring system to work,school, or anywhere else the user might go with people encountered bythe user not becoming aware of the monitoring system. In addition, mostmicroprocessor-based self-care blood glucose monitoring systems have amemory capacity that allows the system to be programmed by themanufacturer so that the monitor displays a sequence of instructionsduring any necessary calibration or system tests and during the bloodglucose test sequence itself. In addition, the system monitors varioussystem conditions during a blood glucose test (e.g., whether a teststrip is properly inserted in the monitor and whether a sufficientamount of blood has been applied to the reagent impregnated portion ofthe strip) and if an error is detected generates an appropriate display(e.g., “retest”). A data port may be provided that allows test resultsstored in the memory of the microprocessor-based blood glucosemonitoring system to be transferred to a data port (e.g., RS-232connection) of a personal computer or other such device for subsequentanalysis.

[0006] Microprocessor-based blood glucose monitoring systems are asignificant advance over previously available self-care systems such asthose requiring a diabetic to apply a blood sample to reagent activatedportions of a test strip; wipe the blood sample from the test stripafter a predetermined period of time; and, after a second predeterminedperiod of time, determine blood glucose level by comparing the color ofthe reagent activated regions of the test strip with a color chartsupplied by the test strip manufacturer. Despite what has been achieved,numerous drawbacks and disadvantages still exist. For example,establishing and maintaining diabetic healthcare often requires thediabetic to record additional data pertaining to medication, foodintake, and exercise. However, the event codes of currently availablemicroprocessor blood glucose monitoring systems provide only limitedcapability for tagging and tracking blood glucose test results accordingto food intake and other relevant factors. For example, the event codesof currently available monitoring systems only allow the user toclassify stored blood glucose readings in a manner that indicates bloodglucose tests taken immediately after a heavy, light or normal meal.This method of recording information not only requires subjectivejudgment by the system user, but will not suffice in a situation inwhich successfully controlling the user's diabetes requires therecording and tracking of relatively accurate information relating tofood intake, exercise, or medication (e.g., insulin dosage). Anotherwise significant advantage of currently available blood glucosemonitoring systems is lost when blood glucose test results must berecorded and tracked with quantitative information relating tomedication, food intake, or exercise. Specifically, the system user mustrecord the required information along with a time and date tagged bloodglucose test result by, for example, writing the information in a logbook.

[0007] The use of event codes to establish subcategories of bloodglucose test results has an additional disadvantage or drawback. Inparticular, although alphanumeric display devices are typically used incurrently available microprocessor-based blood glucose monitoringsystems, the display units are limited to a single line of informationhaving on the order of six characters. Moreover, since the systemsinclude no provision for the user to enter alphanumeric information, anyevent codes that are used must be indicated on the display in a genericmanner, e.g., displayed as “EVENT 1”, EVENT 2” etc. This limitationmakes the system more difficult to use because the diabetic must eithermemorize his or her assignment of event codes or maintain a list thatdefines the event codes. The limited amount of data that can bedisplayed at any one time presents additional drawbacks anddisadvantages. First, instructions and diagnostics that are displayed tothe user when calibrating the system and using the system to obtain ablood glucose reading must be displayed a line at a time and in manycases, the information must be displayed in a cryptic manner.

[0008] The above-discussed display limitations and other aspects ofcurrently available blood glucose monitoring systems is disadvantageousin yet another way. Little statistical information can be made availableto the user. For example, in diabetic healthcare maintenance, changes orfluctuations that occur in blood glucose levels during a day, a week, orlonger period can provide valuable information to a diabetic and/or hisor her healthcare professional. As previously mentioned, currentlyavailable systems do not allow associating blood glucose test resultswith attendant quantitative information relating to medication, foodintake, or other factors such as exercise that affect a person's bloodglucose level at any particular point in time. Thus, currently availableblood glucose monitoring systems have little or no capability for thegenerating and display of trend information that may be of significantvalue to a diabetic or the diabetic's healthcare professional.

[0009] Some currently available blood glucose monitoring systems providea data port that can be interconnected with and transfer data to apersonal computer (e.g., via an RS-232 connection). With such a systemand a suitable programmed computer, the user can generate and displaytrend information or other data that may be useful in administering hisor her treatment plan. Moreover, in such systems, data also can betransferred from the blood glucose monitoring system to a healthcareprofessional's computer either directly or remotely by telephone if boththe blood glucose monitoring system (or computer) to which the data hasbeen downloaded and the healthcare professional's computer are equippedwith modems. Although such a data transfer provision allows a healthcareprofessional to analyze blood glucose data collected by a diabetic, thisaspect of currently available blood glucose monitoring systems has notfound widespread application. First, the downloading and subsequentanalysis feature can only be used by system users that have ready accessto a computer that is programmed with appropriate software and, inaddition, have both the knowledge required to use the software (and theinclination to do so). This same problem exists with respect to datatransfer to (and subsequent analysis by) a healthcare professional.Moreover, various manufacturers of systems that currently provide a datatransfer feature do not use the same data format. Therefore, if ahealthcare professional wishes to analyze data supplied by a number ofdifferent blood glucose monitoring systems, he or she must possesssoftware for each of the systems and must learn to conduct the desiredanalyses with each software system.

[0010] The above-discussed disadvantages and drawbacks ofmicroprocessor-based self-care health monitoring systems take on evengreater significance with respect to children afflicted with diabetes,asthma and other chronic illnesses. In particular, a child's need formedication and other therapy changes as the child grows. Currentmicroprocessor-based self-care health monitoring systems generally donot provide information that is timely and complete enough for ahealthcare professional to recognize and avert problems beforerelatively severe symptoms develop. Too often, a need for a change inmedication and/or other changes in therapeutic regimen is not detecteduntil the child's condition worsens to the point that emergency roomcare is required.

[0011] Further, currently available microprocessor-based healthmonitoring systems have not been designed with children in mind. Aspreviously mentioned, such devices are not configured for sufficientease of use in situations in which it is desirable or necessary torecord and track quantitative information that affects the physicalcondition of the system user (e.g., medication dosage administered by adiabetic and food intake). Children above the age at which they aregenerally capable of obtaining blood samples and administering insulinor other medication generally can learn to use at least the basic bloodglucose monitoring features of currently available microprocessor-basedblood glucose monitoring systems. However, the currently availablemonitoring systems provide nothing in the way of motivation for a childto use the device and, in addition, include little or nothing thateducates the child about his or her condition or treatment progress.

[0012] The lack of provision for the entering of alphanumeric data alsocan be a disadvantage. For example, currently available blood glucosemonitoring systems do not allow the user or the healthcare professionalto enter information into the system such as medication dosage and otherinstructions or data that is relevant to the user's self-care healthprogram.

[0013] The above-discussed disadvantages and drawbacks of currentlyavailable microprocessor-based blood glucose monitoring systems alsohave been impediments to adopting the basic technology of the system forother healthcare situations in which establishing and maintaining aneffective regimen for cure or control is dependent upon (or at leastfacilitated by) periodically monitoring a condition and recording thatcondition along with time and date tags and other information necessaryor helpful in establishing and maintaining a healthcare program.

SUMMARY OF INVENTION

[0014] This invention provides a new and useful system for healthcaremaintenance in which the invention either serves as a peripheral deviceto (or incorporates) a small handheld microprocessor-based unit of thetype that includes a display screen, buttons or keys that allow a userto control the operation of the device and a program cartridge or otherarrangement that can be inserted in the device to adapt the device to aparticular application or function. The invention in effect converts thehandheld microprocessor device into a healthcare monitoring system thathas significant advantages over systems such as the currently availableblood glucose monitoring systems. To perform this conversion, theinvention includes a microprocessor-based healthcare data managementunit, a program cartridge and a monitoring unit. When inserted in thehandheld microprocessor unit, the program cartridge provides thesoftware necessary (program instructions) to program the handheldmicroprocessor unit for operation with the microprocessor-based datamanagement unit. Signal communication between the data management unitand the handheld microprocessor unit is established by an interfacecable. A second interface cable can be used to establish signalcommunication between the data management unit and the monitoring unitor, alternatively, the monitoring unit can be constructed as a plug-inunit having an electrical connector that mates with a connector mountedwithin a region that is configured for receiving the monitoring unit.

[0015] In operation, the control buttons or keys of the handheldmicroprocessor-based unit are used to select the operating mode for boththe data management unit and the handheld microprocessor-based unit. Inresponse to signals generated by the control buttons or keys, the datamanagement unit generates signals that are coupled to the handheldmicroprocessor unit and, under control of the program instructionscontained in the program cartridge, establish an appropriate screendisplay on the handheld microprocessor-based unit display. In selectingsystem operating mode and other operations, the control buttons are usedto position a cursor or other indicator in a manner that allows thesystem user to easily select a desired operating mode or function andprovide any other required operator input. In the disclosed detailedembodiment of the invention several modes of operation are madeavailable.

[0016] In the currently preferred embodiments of the invention, thehandheld microprocessor unit is a compact video game system such as thesystem manufactured by Nintendo of America Inc. under the trademark“GAME BOY.” Use of a compact video game system has several generaladvantages, including the widespread availability and low cost of suchsystems. Further, such systems include switch arrangements that areeasily adapted for use in the invention and the display units of suchsystems are of a size and resolution that can advantageously be employedin the practice of the invention. In addition, such systems alloweducational or motivational material to be displayed to the system user,with the material being included in the program cartridge that providesthe monitor system software or, alternatively, in a separate programcartridge.

[0017] The use of a compact video game system for the handheldmicroprocessor-based unit of the invention is especially advantageouswith respect to children. Specifically, the compact video game systemsof the type that can be employed in the practice of the invention arewell known and well accepted by children. Such devices are easilyoperated by a child and most children are well accustomed to using thedevices in the context of playing video games. Motivational andeducational material relating to the use of the invention can bepresented in game-like or animated format to further enhance acceptanceand use of the invention by children that require self-care healthmonitoring.

[0018] A microprocessor-based health monitoring system that isconfigured in accordance with the invention provides additionaladvantages for both the user and a healthcare professional. Inaccordance with one aspect of the invention, standardized reports areprovided to a physician or other healthcare provider by means offacsimile transmission. To accomplish this, the data management unit ofthe currently preferred embodiments of the invention include a modemwhich allows test results and other data stored in system memory to betransmitted to a remote clearinghouse via a telephone connection. Dataprocessing arrangements included in the clearinghouse perform anyrequired additional data processing; format the standardized reports;and, transmit the reports to the facsimile machine of the appropriatehealthcare professional.

[0019] The clearinghouse also can fill an additional communication need,allowing information such as changes in medication dosage or otherinformation such as modification in the user's monitoring schedule to beelectronically sent to a system user. In arrangements that incorporatethis particular aspect of the invention, information can be sent to theuser via a telephone connection and the data management unit modem whena specific inquiry is initiated by the user, or when the userestablishes a telephone connection with the clearinghouse for otherpurposes such as providing data for standardized reports.

[0020] The clearinghouse-facsimile aspect of the invention is importantbecause it allows a healthcare professional to receive timelyinformation about patient condition and progress without requiring avisit by the patient (system user) and without requiring analysis orprocessing of test data by the healthcare professional. In this regard,the healthcare professional need not possess or even know how to use acomputer and/or the software conventionally employed for analysis ofblood glucose and other health monitoring data and information.

[0021] The invention also includes provision for data analysis andmemory storage of information provided by the user and/or the healthcareprofessional. In particular, the data management units of the currentlypreferred embodiments of the invention include a data port such as anRS-232 connection that allows the system user or healthcare professionalto establish signal communication between the data management unit and apersonal computer or other data processing arrangement. Blood glucosetest data or other information can then be downloaded for analysis andrecord keeping purposes. Alternatively, information such as changes inthe user's treatment and monitoring regimen can be entered into systemmemory. Moreover, if desired, remote communication between the datamanagement unit and the healthcare professional's computer can beestablished using the clearinghouse as an element of the communicationslink. That is, in the currently preferred arrangements of the inventiona healthcare professional has the option of using a personal computerthat communicates with the clearinghouse via a modem and telephone linefor purposes of transmitting instructions and information to a selecteduser of the system and/or obtaining user test data and information forsubsequent analysis.

[0022] The invention can be embodied in forms other than those describedabove. For example, although small handheld microprocessor units such asa handheld video game system or handheld microprocessor units of thetype often referred to as “palm-computers provide many advantages, thereare situations in which other compact microprocessor units canadvantageously be used. Among the various types of units that can beemployed are using compact video game systems of the type that employ aprogram cartridge, but uses a television set or video monitor instead ofa display unit that is integrated into the previously described handheldmicroprocessor units.

[0023] Those skilled in the art also will recognize that theabove-described microprocessor-implemented functions and operations canbe apportioned between one or more microprocessors in a manner thatdiffers from the above-described arrangement. For example, in somesituations, the programmable microprocessor unit and the programcartridge used in practicing the invention may provide memory and signalprocessing capability that is sufficient for practicing the invention.In such situations, the microprocessor of the microprocessor-based datamanagement unit of the above embodiments in effect is moved into thevideo game system, palm-computer or programmable microprocessor device.In such an arrangement, the data management unit can be realized as arelatively simple interface unit that includes little or no signalprocessing capability. Depending upon the situation at hand, theinterface unit may or may not include a telephone modem and/or an RS-232connection (or other data port) for interconnecting the healthcaresystem with a computer or other equipment. In other situations, thefunctions and operations associated with processing of the monitoredhealth care data may be performed by a microprocessor that is added toor already present in the monitoring device that is used to monitorblood glucose or other condition.

[0024] Because the invention can be embodied to establish systems havingdifferent levels of complexity, the invention satisfies a wide range ofself-care health monitoring applications. The arrangements that includea modem (or other signal transmission facility) and sufficient signalprocessing capability can be employed in situations in which reports areelectronically transmitted to a healthcare professional either in hardcopy (facsimile) form or in a signal format that can be received by andstored in the healthcare professional's computer. On the other hand,less complex (and, hence, less costly) embodiments of the invention areavailable for use in which transfer of system information need not bemade by means of telephonic data transfer or other remote transmissionmethods. In these less complex embodiments, transfer of data to ahealthcare professional can still be accomplished. Specifically, if theprogram cartridge includes a battery and suitable program instructions,monitored healthcare data can be stored in the program cartridge duringuse of the system as a healthcare monitor. The data cartridge can thenbe provided to the healthcare professional and inserted in aprogrammable microprocessor-based unit that is the same as or similar tothat which was used in the healthcare monitoring system. The healthcareprofessional can then review the data, and record it for later use,and/or can use the data in performing various analyses. If desired, themicroprocessor-based unit used by the healthcare professional can beprogrammed and arranged to allow information to be stored in thecartridge for return to and retrieval by the user of the healthcaremonitoring system. The stored information can include messages (e.g.,instructions for changes in medication dosage) and/or programinstructions for reconfiguring the program included in the cartridge soas to effect changes in the treatment regimen, the analyses or reportsto be generated by the healthcare monitoring system, or less importantaspects such as graphical presentation presented during the operation ofthe healthcare system.

BRIEF DESCRIPTION OF DRAWINGS

[0025] The foregoing aspects and many of the attendant advantages ofthis invention will become more readily appreciated as the same becomesbetter understood by reference to the following detailed description,when taken in conjunction with the accompanying drawings, wherein:

[0026]FIG. 1 is a block diagram that illustrates a healthcare monitoringsystem arranged in accordance with the invention;

[0027]FIG. 2 diagrammatically illustrates monitoring systems constructedin accordance with the invention connected in signal communication witha remotely located computing facility which includes provision formaking the data supplied by the monitoring system of the inventionavailable to a designated healthcare professional and/or for providingdata and instructions to the system user;

[0028]FIG. 3 is a block diagram diagrammatically depicting thestructural arrangement of the system data management unit and itsinterconnection with other components of the system shown in FIG. 1.

[0029] FIGS. 4-10 depict typical system screen displays of data andinformation that can be provided by the arrangements shown in FIGS. 1-3;and

[0030]FIG. 11 diagrammatically illustrates an alternative healthcaremonitoring system that is arranged in accordance with the invention.

DETAILED DESCRIPTION

[0031]FIG. 1 depicts a self-care health monitoring system arranged inaccordance with the invention. In the arrangement shown in FIG. 1 a datamanagement unit 10 is electrically interconnected with a handheldmicroprocessor-based unit 12 via a cable 14. In the depictedarrangement, data management unit 10 also is electrically interconnectedwith a blood glucose monitor 16 of the type capable of sensing bloodglucose level and producing an electrical signal representative thereof.Although FIG. 1 illustrates blood glucose monitor 16 as being connectedto data management unit 10 by a cable 18, it may be preferable toconstruct blood glucose monitor 16 as a plug-in unit that is placed in arecess or other suitable opening or slot in data management unit 10.Regardless of the manner in which blood glucose monitor 16 isinterconnected with data management unit 10, both that interconnectionand cable 14 are configured for serial data communication between theinterconnected devices.

[0032] Also shown in FIG. 1 are two additional monitoring devices 20 and22, which are electrically connected for serial data communication withdata management unit 10 via cables 24 and 26, respectively. Monitoringunits 20 and 22 of FIG. 1 represent devices other than blood glucosemonitor 16 that can be used to configure the invention for self-carehealth monitoring applications other than (or in addition to) diabetescare. For example, as is indicated in FIG. 1 the monitoring device 20can be a peak-flow meter that provides a digital signal representativeof the airflow that results when a person suffering from asthma oranother chronic respiratory affliction expels a breath of air throughthe meter. As is indicated by monitor 22 of FIG. 1 various other devicescan be provided for monitoring conditions such as blood pressure, pulse,and body temperature to thereby realize systems for self-care monitoringand control of conditions such as hypertension, certain heart conditionsand various other afflictions and physical conditions. Uponunderstanding the hereinafter discussed aspects and features of theinvention it will be recognized that the invention is easily implementedfor these and other types of healthcare monitoring. In particular,monitors used in the practice of the invention can be arranged in avariety of ways as long as the data to be recorded or otherwise employedby handheld microprocessor unit and/or data management unit 10 isprovided in serial format in synchronization with clock signals providedby data management unit 10. As is the case with blood glucose monitor16, the additional monitors can be configured as plug-in units that aredirectly received by data management unit 10, or can be connected todata management unit 10 with cables (as shown in FIG. 1).

[0033] As is shown in FIG. 1, handheld microprocessor unit 12 includes adisplay screen 28 and a plurality of switches or keys (30, 32, 34, 36,and 38 in FIG. 1) which are mounted on a housing 40. Located in theinterior of housing 40, but not shown in FIG. 1 are a microprocessor,memory circuits, and circuitry that interfaces switches 30, 32, 34, 36,and 38 with the microprocessor. Stored in the memory of program handheldmicroprocessor unit 12 is a set of program instructions that establishesa data protocol that allows handheld microprocessor unit 12 to performdigital data signal processing and generate desired data or graphics fordisplay on display unit 28 when a program cartridge 42 is inserted in aslot or other receptacle in housing 40. That is, program cartridge 42 ofFIG. 1 includes read-only memory units (or other memory means such asbattery-powered random access memory) which store program instructionsand data that adapt handheld microprocessor 12 for operation in a bloodglucose monitoring system. More specifically, when the instructions anddata of program cartridge 42 are combined with program instructions anddata included in the internal memory circuits of handheld microprocessorunit 12 handheld microprocessor unit 12 is programmed for processing anddisplaying blood glucose information in the manner described below andadditional monitors 22 to provide health monitoring for asthma andvarious other previously mentioned chronic conditions. In each case, theplurality of switches or keys (30, 32, 34, 36 and 38 in FIG. 1) areselectively operated to provide signals that result in pictorial and/oralphanumeric information being displayed by display unit 42.

[0034] Various devices are known that meet the above-set forthdescription of handheld microprocessor unit 12. For example, compactdevices are available in which the plurality of keys allows alphanumericentry and internal memory is provided for storing information such asnames, addresses, phone numbers, and an appointment calendar. Smallprogram cartridges or cards can be inserted in these devices to programthe device for various purposes such as the playing of games,spreadsheet application, and foreign language translation sufficient foruse in travel. More recently, less compact products that have moreextensive computational capability and are generally called “palm topcomputers” have been introduced into the marketplace. These devices alsocan include provision for programming the device by means of aninsertable program card or cartridge.

[0035] The currently preferred embodiments of the invention areconfigured and arranged to operate in conjunction with yet another typeof handheld microprocessor unit. Specifically, in the currentlypreferred embodiments of the invention, program cartridge 42 iselectrically and physically compatible with commercially availablecompact video game systems, such as the system manufactured by Nintendoof America Inc. under the trademark “GAME BOY.” Configuring datamanagement unit 10 and program cartridge 42 for operation with ahandheld video game system has several advantages. For example, thedisplay unit of such a device provides display resolution that allowsthe invention to display both multi-line alphanumeric information andgraphical data. In this regard, the 160×144 pixel dot matrix-type liquidcrystal display screen currently used in the above-referenced compactvideo game systems provides sufficient resolution for at least six linesof alphanumeric text, as well as allowing graphical representation ofstatistical data such as graphical representation of blood glucose testresults for a day, a week, or longer.

[0036] Another advantage of realizing handheld microprocessor unit 12 inthe form of a compact video game system is the relatively simple, yetversatile arrangement of switches that is provided by such a device. Forexample, as is indicated in FIG. 1 a compact video game system includesa control pad that allows an object displayed on display unit 42 to bemoved in a selected direction (i.e., up-down or left-right). As also isindicated in FIG. 1, compact video game systems typically provide twopair of distinctly-shaped push button switches. In the arrangement shownin FIG. 1, a pair of spaced-apart circular push button switches (36 and38) and a pair of elongate switches (32 and 34) are provided. Thefunctions performed by the two pairs of switches is dependent upon theprogram instructions contained in each program cartridge 42.

[0037] Yet another advantage of utilizing a compact video game systemfor handheld microprocessor-based unit 12 of FIG. 1 is the widespreadpopularity and low cost of such units. In this regard, manufacture andsale of a data management unit blood glucose monitor 16 and programcartridge 42 that operate in conjunction with a compactmicroprocessor-based video allows the self-care health monitoring systemof FIG. 1 to be manufactured and sold at a lower cost than could berealized in an arrangement in which handheld unit 12 is designed andmanufactured solely for use in the system of FIG. 1.

[0038] An even further advantage of using a compact video game systemfor handheld microprocessor 12 is that such video game systems includemeans for easily establishing the electrical interconnection provided bycable 14 in FIG. 1. In particular, such compact video game systemsinclude a connector mounted to the game unit housing (40 in FIG. 1) anda cable that can be connected between the connectors of two video gameunits to allow interactive operation of the two interconnected units(i.e., to allow contemporaneous game play by two players or competitionbetween players as they individually play identical but separate games).In the preferred embodiments of the invention, the “two-player” cablesupplied with the compact video game unit being used as handheldmicroprocessor unit 12 is used as cable 14 to establish serial datacommunication between the handheld microprocessor unit 12 (compact videogame system) and data management unit 10. In these preferredembodiments, the program instructions stored on the memory of datamanagement unit 10 and program cartridge 42 respectively program datamanagement unit 10 and the compact video game system (i.e., handheldmicroprocessor unit 12) for interactive operation in which switches 30,32, 34, 36 and 38 are used to control the operation of data managementunit 10 (e.g., to select a particular operational mode such asperformance of a blood glucose test or the display of statistical testdata and, in addition, to control operation such as selection of anoption during operation of the system in a particular operational mode).In each operational mode, data management unit 10 processes data inaccordance with program instructions stored in the memory circuits ofdata management unit 10. Depending upon the operational mode selected bythe user, data is supplied to data management unit 10 by blood glucosemonitor 16 by additional monitors (20 and 22 in FIG. 1) or anyinterconnected computers or data processing facility (such as thehereinafter described user's computer 48 and clearinghouse 54 of FIG. 1)During such operation, mode switches 30, 32, 34, 36 and 38 areselectively activated so that signals are selectively coupled to thevideo game system (handheld microprocessor unit 12) and processed inaccordance with program instructions stored in program cartridge 42. Thesignal processing performed by handheld microprocessor unit 12 resultsin the display of alphanumeric, symbolic, or graphic information on thevideo game display screen (i.e., display unit 28 in FIG. 1) which allowthe user to control system operation and obtain desired test results andother information.

[0039] Although the above-discussed advantages apply to use of theinvention by all age groups, employing a compact video game system inthe practice of the invention is of special significance in monitoring achild's blood glucose or other health parameters. Children and youngadults are familiar with compact video game systems. Thus, children willaccept a health monitoring system incorporating a compact video gamesystem more readily than a traditional system, even an embodiment of theinvention that uses a different type of handheld microprocessor unit.Moreover, an embodiment of the invention that functions in conjunctionwith a compact video game system can be arranged to motivate children tomonitor themselves more closely than they might otherwise byincorporating game-like features and/or animation in system instructionand test result displays. Similarly, the program instructions can beincluded in program cartridges 41, 42 and 43 (or additional cartridges)that allow children to select game-like displays that help educate thechild about his or her condition and the need for monitoring.

[0040] With continued reference to FIG. 1, data management unit 10 ofthe currently preferred embodiments of the invention includes a dataport 44 that allows communication between data management unit 10 and apersonal computer 48 (or other programmable data processor). In thecurrently preferred embodiments of the invention, data port 44 is anRS-232 connection that allows serial data communication between datamanagement unit 10 and personal computer 48. In the practice of theinvention, personal computer 48 can be used to supplement datamanagement unit 10 by, for example, performing more complex analyses ofblood glucose and other data that has been supplied to and stored in thememory circuits of data management unit 10. With respect to embodimentsof the invention configured for use by a child, personal computer 48 canbe used by a parent or guardian to review and analyze the child'sprogress and to produce printed records for subsequent review by ahealthcare professional. Alternatively, personal computer 48 can be usedto supply data to data management unit 10 that is not convenientlysupplied by using handheld microprocessor switches 30, 32, 34, 36 and 38as an operator interface to the system shown in FIG. 1. For example,some embodiments of the invention may employ a substantial amount ofalphanumeric information that must be entered by the system user.Although it is possible to enter such data by using switches 30, 32, 34,36, and 38 in conjunction with menus and selection screens displayed ondisplay screen 28 of FIG. 1 it may be more advantageous to use a devicesuch as personal computer 48 for entry of such data. However, ifpersonal computer 48 is used in this manner, some trade-off of systemfeatures may be required because data management unit 10 must betemporarily interconnected with personal computer 48 during theseoperations. That is, some loss of system mobility might result because asuitably programmed personal computer would be needed at each locationat which data entry or analysis is to occur.

[0041] As is indicated in FIG. 1, data management unit 10 of thecurrently preferred embodiments of the invention also includes a modemthat allows data communication between data management unit 10 and aremote computing facility identified in FIG. 1 as clearinghouse 54 via aconventional telephone line (indicated by reference numeral 50 inFIG. 1) and a modem 52 that interconnects clearinghouse 54 and telephoneline 50. As shall be described in more detail, clearinghouse 54computing facility 54 facilitates communication between a user of thesystem shown in FIG. 1 and his or her healthcare professional and canprovide additional services such as updating system software. As isindicated by facsimile machine 55 of FIG. 1 a primary function ofclearinghouse 54 is providing the healthcare professional withstandardized reports 56, which indicate both the current condition andcondition trends of the system user. Although a single facsimile machine55 is shown in FIG. 1, it will be recognized that numerous healthcareprofessionals (and hence facsimile machine 55) can be connected insignal communication with a clearinghouse 54.

[0042] Regardless of whether a compact video game system, another typeof commercially available handheld microprocessor-based unit, or aspecially designed unit is used, the preferred embodiments of FIG. 1provide a self-care blood glucose monitoring system in which programcartridge (a) handheld microprocessor unit 12 for displayinginstructions for performing the blood glucose test sequence andassociated calibration and test procedures; (b) handheld microprocessorunit 12 for displaying (graphically or alphanumerically) statisticaldata such as blood glucose test results taken during a specific periodof time (e.g., a day, week, etc.); (c) handheld microprocessor unit 12for supplying control signals and signals representative of food intakeor other useful information to data management unit 10; (d) handheldmicroprocessor unit 12 for simultaneous graphical display of bloodglucose levels with information such as food intake; and, (e) handheldmicroprocessor unit 12 for displaying information or instructions from ahealthcare professional that are coupled to data management unit 10 froma clearinghouse 54. The manner in which the arrangement of FIG. 1implements the above-mentioned functions and others can be betterunderstood with reference to FIGS. 2 and 3.

[0043] Referring first to FIG. 2, clearinghouse 54 receives data from aplurality of self-care microprocessor-based healthcare systems of thetype shown in FIG. 1, with the individual self-care health monitoringsystems being indicated in FIG. 2 by reference numeral 58. Preferably,the data supplied to clearinghouse 54 by each individual self-carehealth monitoring system 58 consists of “raw data,” i.e., test resultsand related data that was stored in memory circuits of data managementunit 10, without further processing by data management unit 10. Forexample, with respect to the arrangement shown in FIG. 1, blood glucosetest results and associated data such as food intake information,medication dosage and other such conditions are transmitted toclearinghouse 54 and stored with a digitally encoded signal thatidentifies both the source of the information (i.e., the system user orpatient) and those having access to the stored information (i.e., thesystem user's doctor or other healthcare professional).

[0044] As shall be recognized upon understanding the manner in which itoperates, clearinghouse 54 can be considered to be a central server forthe various system users (58 in FIG. 2) and each healthcare professional60. In that regard, clearinghouse 54 includes conventionally arrangedand interconnected digital processing equipment (represented in FIG. 2by digital signal processor 57) which receives digitally encodedinformation from a user 58 or healthcare professional processes theinformation as required; stores the information (processed orunprocessed) in memory if necessary; and, transmits the information toan intended recipient (i.e., user 58 or healthcare professional 60).

[0045] In FIG. 2 rectangular outline 60 represents one of numerousremotely located healthcare professionals who can utilize clearinghouse54 and the arrangement described relative to FIG. 1 in monitoring andcontrolling patient healthcare programs. Shown within outline 60 is acomputer 62 (e.g., personal computer), which is coupled to clearinghouse54 by means of a modem (not shown in FIG. 2) and a telephone line 64.Also shown in FIG. 2 is the previously mentioned facsimile machine 55,which is coupled to clearinghouse 54 by means of a second telephone line68. Using the interface unit of computer 62 (e.g., a keyboard orpointing device such as a mouse), the healthcare professional canestablish data communication between computer 62 and clearinghouse 54via telephone line 64. Once data communication is established betweencomputer 62 and clearinghouse 54 patient information can be obtainedfrom clearinghouse 54 in a manner similar to the manner in whichsubscribers to various database services access and obtain information.In particular, the healthcare professional can transmit an authorizationcode to clearinghouse 54 that identifies the healthcare professional asan authorized user of the clearinghouse and, in addition, can transmit asignal representing the patient for which healthcare information isbeing sought. As is the case with conventional database services andother arrangements, the identifying data is keyed into computer 62 bymeans of a conventional keyboard (not shown in FIG. 2) in response toprompts that are generated at clearinghouse 54 for display by thedisplay unit of computer 62 (not shown in FIG. 2).

[0046] Depending upon the hardware and software arrangement ofclearinghouse 54 and selections made by the healthcare professional viacomputer 62 patient information can be provided to the healthcareprofessional in different ways. For example, computer 62 can be operatedto access data in the form that it is stored in the memory circuits ofclearinghouse 54 (i.e., raw data that has not been processed or alteredby the computational or data processing arrangements of clearinghouse54). Such data can be processed, analyzed, printed and/or displayed bycomputer 62 using commercially available or custom software. On theother hand, various types of analyses may be performed by clearinghouse54 with the results of the analyses being transmitted to the remotelylocated healthcare professional 60. For example, clearinghouse 54 canprocess and analyze data in a manner identical to the processing andanalysis provided by the self-care monitoring system of FIG. 1. Withrespect to such processing and any other analysis and processingprovided by clearinghouse 54 results expressed in alphanumeric formatcan be sent to computer 62 via telephone line 64 and the modemassociated with computer 62 with conventional techniques being used fordisplaying and/or printing the alphanumeric material for subsequentreference.

[0047] The arrangement of FIG. 2 also allows the healthcare professionalto send messages and/or instructions to each patient via computer 62telephone line 64 and clearinghouse 54. In particular, clearinghouse 54can be programmed to generate a menu that is displayed by computer 62and allows the healthcare professional to select a mode of operation inwhich information is to be sent to clearinghouse 54 for subsequenttransmission to a user of the system described relative to FIG. 1. Thissame menu (or related submenus) can be used by the healthcareprofessional to select one or more modes of operation of theabove-described type in which either unmodified patient data or theresults of data that has been analyzed by clearinghouse 54 is providedto the healthcare provider via computer 62 and/or facsimile machine 55.

[0048] In the currently contemplated arrangements, operation of thearrangement of FIG. 2 to provide the user of the invention with messagesor instructions such as changes in medication or other aspects of thehealthcare program is similar to the operation that allows thehealthcare professional to access data sent by a patient, i.e.,transmitted to clearinghouse 54 by a data management unit 10 of FIG. 1.The process differs in that the healthcare professional enters thedesired message or instruction via the keyboard or other interface unitof computer 62. Once the data is entered and transmitted toclearinghouse 54 it is stored for subsequent transmission to the userfor whom the information or instruction is intended.

[0049] With respect to transmitting stored messages or instructions to auser of the invention, at least two techniques are available. The firsttechnique is based upon the manner in which operational modes areselected in the practice of the invention. Specifically, in thecurrently preferred embodiments of the invention, program instructionsthat are stored in data management unit 10 and program cartridge 42cause the system of FIG. 1 to generate menu screens which are displayedby display unit 28 of handheld microprocessor unit 12. The menu screensallow the system user to select the basic mode in which the system ofFIG. 1 is to operate and, in addition, allow the user to selectoperational subcategories within the selected mode of operation. Varioustechniques are known to those skilled in the art for displaying andselecting menu items. For example, in the practice of this invention,one or more main menus can be generated and displayed which allow thesystem user to select operational modes that may include: (a) a monitormode (e.g., monitoring of blood glucose level); (b) a display mode(e.g., displaying previously obtained blood glucose test results orother relevant information); (c) an input mode (e.g., a mode forentering data such as providing information that relates to thehealthcare regimen, medication dosage, food intake, etc.); and, (d) acommunications mode (for establishing a communication link between datamanagement unit 10 and personal computer 48 of FIG. 1 or between datamanagement unit 10 and a remote computing facility such as clearinghouse54 of FIG. 2.

[0050] In embodiments of the invention that employ a compact video gamesystem for handheld microprocessor unit 12 the selection of menu screensand the selection of menu screen items preferably is accomplished insubstantially the same manner as menu screens and menu items areselected during the playing of a video game. For example, the programinstructions stored in data management unit 10 and program cartridge 42of the arrangement of FIG. 1 can be established so that a predeterminedone of the compact video game switches (e.g., switch 32 in FIG. 1)allows the system user to select a desired main menu in the event thatmultiple main menus are employed. When the desired main menu isdisplayed, operation by the user of control pad 30 allows a cursor orother indicator that is displayed on the menu to be positioned adjacentto or over the menu item to be selected. Activation of a switch (e.g.,switch 36 of the depicted handheld microprocessor unit causes thehandheld microprocessor unit 12) and/or data management unit 10 toinitiate the selected operational mode or, if selection of operationalsubmodes is required, causes handheld microprocessor unit 12 to displaya submenu.

[0051] In view of the above-described manner in which menus and submenusare selected and displayed, it can be recognized that the arrangement ofFIG. 1 can be configured and arranged to display a menu or submenu itemthat allows the user to obtain and display messages or instructions thathave been provided by a healthcare professional and stored inclearinghouse 54. For example, a submenu that is generated uponselection of the previously mentioned communications mode can includesubmenu items that allow the user to select various communication modes,including a mode in which serial data communication is establishedbetween data management unit 10 and clearinghouse 54 and data managementunit 10 transmits a message status request to clearinghouse 54. Whenthis technique is used, the data processing system of clearinghouse 54is programmed to search the clearinghouse memory to determine whether amessage exists for the user making the request. Any messages stored inmemory for that user are then transmitted to the user and processed fordisplay on display unit 28 of handheld microprocessor unit 12. If nomessages exist, clearinghouse 54 transmits a signal that causes displayunit 28 to indicate “no messages.” In this arrangement, clearinghouse 54preferably is programmed to store a signal indicating that a storedmessage has been transmitted to the intended recipient (user). Storingsuch a signal allows the healthcare professional to determine thatmessages sent to clearinghouse 54 for forwarding to a patient have beentransmitted to that patient. In addition, the program instructionsstored in data management unit 10 of FIG. 1 preferably allow the systemuser to designate whether received messages and instructions are to bestored in the memory of data management unit 10 for subsequent retrievalor review. In addition, in some instances it may be desirable to programclearinghouse 54 and data management unit 10 so that the healthcareprofessional can designate (i.e., flag) information such as changes inmedication that will be prominently displayed to the user (e.g.,accompanied by a blinking indicator) and stored in the memory of datamanagement unit 10 regardless of whether the system user designates theinformation for storage.

[0052] A second technique that can be used for forwarding messages orinstructions to a user does not require the system user to select a menuitem requesting transmission by clearinghouse 54 of messages that havebeen stored for forwarding to that user. In particular, clearinghouse 54can be programmed to operate in a manner that either automaticallytransmits stored messages for that user when the user operates thesystem of FIG. 1 to send information to the clearinghouse or programmedto operate in a manner that informs the user that messages are availableand allows the user to access the messages when he or she chooses to doso.

[0053] Practicing the invention in an environment in which thehealthcare professional uses a personal computer in some or all of theabove-discussed ways can be very advantageous. On the other hand, theinvention also provides healthcare professionals timely informationabout system users without the need for a computer (62 in FIG. 2) or anyequipment other than a conventional facsimile machine (55 in FIGS. 1 and2) Specifically, information provided to clearinghouse 54 by a systemuser 58 can be sent to a healthcare professional 60 via telephone line68 and facsimile machine 55 with the information being formatted as astandardized graphic or textual report (56 in FIG. 1) Formatting astandardized report 56 (i.e., analyzing and processing data supplied byblood glucose monitor 16 or other system monitor or sensor) can beeffected either by data management unit 10 or within the clearinghousefacility 54. Moreover, various standardized reports can be provided(e.g., the textual and graphic displays discussed below relating toFIGS. 6-10) Preferably, the signal processing arrangement included inclearinghouse 54 allows each healthcare professional 60 to select whichof several standardized reports will be routinely transmitted to thehealthcare professionals' facsimile machine 55 and, to do so on apatient-by-patient (user-by-user) basis.

[0054]FIG. 3 illustrates the manner in which data management unit 10 isarranged and interconnected with other system components for effectingthe above-described operational aspects of the invention and additionalaspects that are described relative to FIGS. 4-10. As is symbolicallyindicated in FIG. 3, handheld microprocessor unit 12 and blood glucosemonitor 16 are connected to a dual universal asynchronous receivertransmitter 70 (e.g., by cables 14 and 18 of FIG. 1, respectively). Asalso is indicated in FIG. 3 when a system user connects a personalcomputer 48 (or other programmable digital signal processor) to dataport 44 signal communication is established between personal computer 48and a second dual universal asynchronous receiver transmitter 72 of datamanagement unit 10. Additionally, dual universal asynchronous receivertransmitter 72 is coupled to modem 46 so that data communication can beestablished between data management unit 10 and a remote clearinghouse54 of FIGS. 1 and 2.

[0055] Currently preferred embodiments of data management unit 10include a plurality of signal sensors 74, with an individual signalsensor being associated with each device that is (or may be)interconnected with data management unit 10. As previously discussed andas is indicated in FIG. 3, these devices include handheld microprocessorunit 12, blood glucose monitor 16, personal computer 48, remotecomputing facility 54, and, in addition, peak-flow meter 20 or otheradditional monitoring devices 22. Each signal sensor 74 that is includedin data management unit 10 is electrically connected for receiving asignal that will be present when the device with which that particularsignal sensor is associated is connected to data management unit 10 and,in addition, is energized (e.g., turned on). For example, in previouslymentioned embodiments of the invention in which data port 44 is anRS-232 connection, the signal sensor 74 that is associated with personalcomputer 48 can be connected to an RS-232 terminal that is suppliedpower when a personal computer is connected to data port 44 and thepersonal computer is turned on. In a similar manner, the signal sensor74 that is associated with clearinghouse 54 can be connected to modem 46so that the signal sensor 74 receives an electrical signal when modem 46is interconnected to a remote computing facility (e.g., clearinghouse 54of FIG. 2) via a telephone line 50.

[0056] In the arrangement of FIG. 3, each signal sensor 74 is a lowpower switch circuit (e.g., a metal-oxide semiconductor field-effecttransistor circuit), which automatically energizes data management unit10 whenever any one (or more) of the devices associated with signalsensors 74 is connected to data management unit 10 and is energized.Thus, as is indicated in FIG. 3 by signal path 76 ach signal sensor is74 interconnected with power supply 78 which supplies operating currentto the circuitry of data management unit 10 and typically consists ofone or more small batteries (e.g., three AAA alkaline cells). Themicroprocessor and other conventional circuitry that enables datamanagement unit 10 to process system signals in accordance with storedprogram instructions is indicated in FIG. 3 by central processing unit(CPU) 80. As is indicated in FIG. 3 by interconnection 82 between CPU 80and battery 78. CPU 80 receives operating current from power supply 78with power being provided only when one or more of the signal sensors 74are activated in the previously described manner. A clock/calendarcircuit 84 is connected to CPU (80 via signal path 86 in FIG. 3) toallow time and date tagging of blood glucose tests and otherinformation. Although not specifically shown in FIG. 3, operating poweris supplied to clock/calendar 84 at all times.

[0057] In operation, CPU 80 receives and sends signals via a data bus(indicated by signal path 88 in FIG. 3) which interconnects CPU 80 withdual universal asynchronous receiver transmitters 70 and 72. The databus 88 also interconnects CPU 80 with memory circuits which, in thedepicted embodiment, include a system read-only memory (ROM) 90 aprogram random access memory (RAM) 92 and an electronically erasableread-only memory (EEROM) 94. System ROM 90 stores program instructionsand any data required in order to program data management unit 10 sothat data management unit 10 and a handheld microprocessor unit 12 thatis programmed with a suitable program cartridge 42 provide thepreviously discussed system operation and, in addition, system operationof the type described relative to FIGS. 4-10. During operation of thesystem, program RAM 92 provides memory space that allows CPU 80 to carryout various operations that are required for sequencing and controllingthe operation of the system of FIG. 1. In addition, RAM 92 can providememory space that allows external programs (e.g., programs provided byclearinghouse 54 to be stored and executed. EEROM 94 allows bloodglucose test results and other data information to be stored andpreserved until the information is no longer needed (i.e., untilpurposely erased by operating the system to provide an appropriate erasesignal to EEROM 94).

[0058] FIGS. 4-10 illustrate typical screen displays that are generatedby the arrangement of the invention described relative to FIGS. 1-3.Reference will first be made to FIGS. 4 and 5 which exemplify screendisplays that are associated with operation of the invention in theblood glucose monitoring mode. Specifically, in the currently preferredembodiments of the invention, blood glucose monitor 16 operates inconjunction with data management unit 10 and handheld microprocessorunit 12 to: (a) a test or calibration sequence in which tests areperformed to confirm that the system is operating properly; and, (b) theblood glucose test sequence in which blood glucose meter 16 senses theuser's blood glucose level. Suitable calibration procedures for bloodglucose monitors are known in the art. For example, blood glucosemonitors often are supplied with a “code strip,” that is inserted in themonitor and results in a predetermined value being displayed and storedin memory at the conclusion of the code strip calibration procedure.When such a code strip calibration procedure is used in the practice ofthe invention, the procedure is selected from one of the system menus.For example, if the system main menu includes a “monitor” menu item, asubmenu displaying system calibration options and an option forinitiating the blood glucose test may be displayed when the monitor menuitem is selected. When a code strip option is available and selected, asequence of instructions is generated and displayed by display screen 28of handheld microprocessor unit 12 to prompt the user to insert the codestrip and perform all other required operations. At the conclusion ofthe code strip calibration sequence, display unit 28 of handheldmicroprocessor unit 12 displays a message indicating whether or not thecalibration procedure has been successfully completed. For example, FIG.4 illustrates a screen display that informs the system user that thecalibration procedure was not successful and that the code strip shouldbe inserted again (i.e., the calibration procedure is to be repeated).As is indicated in FIG. 4, display screens that indicate a potentialmalfunction of the system include a prominent message such as the“Attention” notation included in the screen display of FIG. 4.

[0059] As previously indicated, the blood glucose test sequence that isemployed in the currently preferred embodiment of the invention is ofthe type in which a test strip is inserted in a receptacle that isformed in the blood glucose monitor. A drop of the user's blood is thenapplied to the test strip and a blood glucose sensing sequence isinitiated. When the blood glucose sensing sequence is complete, theuser's blood glucose level is displayed.

[0060] In the practice of the invention, program instructions stored indata management unit 10 (e.g., system ROM 90 of FIG. 3) and programinstructions stored in program cartridge 42 of handheld microprocessorunit 12 cause the system to display step-by-step monitoring instructionsto the system user and, in addition, preferably result in display ofdiagnostic messages if the test sequence does not proceed in a normalfashion. Although currently available self-containedmicroprocessor-based blood glucose monitors also display testinstruction and diagnostic messages, the invention provides greatermessage capacity and allows multi-line instructions and diagnosticmessages that are displayed in easily understood language rather thancryptic error codes and abbreviated phraseology that is displayed oneline or less at a time. For example, as is shown in FIG. 5 the completeresults of a blood glucose test (date, time of day, and blood glucoselevel in milligrams per deciliter) can be concurrently displayed bydisplay screen 28 of handheld microprocessor unit 12 along with aninstruction to remove the test strip from blood glucose monitor 16. Aspreviously mentioned, when the blood glucose test is complete, the timeand date tagged blood glucose test result is stored in the memorycircuits of data management unit 10 (e.g., stored in EEPROM 94 of FIG.3)

[0061] The arrangement shown and described relative to FIGS. 1-3 also isadvantageous in that data relating to food intake, concurrent medicationdosage and other conditions easily can be entered into the system andstored with the time and date tagged blood glucose test result for laterreview and analysis by the user and/or his or her healthcareprofessional. Specifically, a menu generated by the system at thebeginning or end of the blood glucose monitoring sequence can includeitems such as “hypoglycemic” and “hyperglycemic,” which can be selectedusing the switches of handheld microprocessor unit 12 (e.g., operationof control pad 30 and switch 36 in FIG. 1) to indicate the user wasexperiencing hypoglycemic or hyperglycemic symptoms at the time ofmonitoring blood glucose level. Food intake can be quantitativelyentered in terms of “Bread Exchange” units or other suitable terms by,for example, selecting a food intake menu item and using a submenudisplay and the switches of handheld microprocessor 12 to select andenter the appropriate information. A similar menu item—submenu selectionprocess also can be used to enter medication data such as the type ofinsulin used at the time of the glucose monitoring sequence and thedosage.

[0062] As was previously mentioned, program instructions stored in datamanagement unit 10 and program instructions stored in program cartridge42 of handheld microprocessor unit 12 enable the system to displaystatistical and trend information either in a graphic or alphanumericformat. As is the case relative to controlling other operational aspectsof the system, menu screens are provided that allow the system user toselect the information that is to be displayed. For example, in thepreviously discussed embodiments in which a system menu includes a“display” menu item, selection of the menu item results in the displayof one or more submenus that list available display options. Forexample, in the currently preferred embodiments, the user can selectgraphic display of blood glucose test results over a specific period oftime, such as one day, or a particular week. Such selection results indisplays of the type shown in FIGS. 6 and 7 respectively. When bloodglucose test results for a single day are displayed (FIG. 6) the day ofthe week and date can be displayed along with a graphic representationof changes in blood glucose level between the times at which testresults were obtained. In the display of FIG. 6, small icons identifypoints on the graphic representation that correspond to the bloodglucose test results (actual samples). Although not shown in FIG. 6,coordinate values for blood glucose level and time of day can bedisplayed if desired. When the user chooses to display a weekly trendgraph (FIG. 7) the display generated by the system is similar to thedisplay of a daily graph, having the time period displayed inconjunction with a graph that consists of lines interconnecting pointsthat correspond to the blood glucose test results.

[0063] The screen display shown in FIG. 8 is representative ofstatistical data that can be determined by the system of FIG. 1 (usingconventional computation techniques) and displayed in alphanumericformat. As previously mentioned, such statistical data and informationin various other textual and graphic formats can be provided to ahealthcare professional (60 in FIG. 2) in the form of a standardizedreport 56 (FIG. 1) that is sent by clearinghouse 54 to facsimile machine55. In the exemplary screen display of FIG. 8, statistical data forblood glucose levels over a period of time (e.g., one week) or,alternatively, for a specified number of monitoring tests is provided.In the exemplary display of FIG. 8 the system (data management unit 10or clearinghouse 54) also calculates and displays (or prints) theaverage blood glucose level and the standard deviation. Displayed alsois the number of blood glucose test results that were analyzed to obtainthe average and the standard deviation; the number of test results undera predetermined level (50 milligrams per deciliter in FIG. 8) and thenumber of blood glucose tests that were conducted while the user wasexperiencing hypoglycemic symptoms. As previously noted, in thepreferred embodiments of the invention, a screen display that isgenerated during the blood glucose monitoring sequence allows the userto identify the blood sample being tested as one taken whileexperiencing hyperglycemic or hypoglycemic symptoms and, in addition,allows the user to specify other relevant information such as foodintake and medication information.

[0064] The currently preferred embodiments of the invention also allowthe user to select a display menu item that enables the user tosequentially address, in chronological order, the record of each bloodglucose test. As is indicated in FIG. 9, each record presented to thesystem user includes the date and time at which the test was conducted,the blood glucose level, and any other information that the userprovided. For example, the screen display of FIG. 9 indicates that theuser employed handheld microprocessor unit 12 as an interface to enterdata indicating use of 12.5 units of regular insulin; 13.2 units of“NPH” insulin; food intake of one bread exchange unit; and pre-mealhypoglycemic symptoms.

[0065] Use of data management unit 10 in conjunction with handheldmicroprocessor unit 12 also allows display (or subsequent generation ofa standardized report showing blood glucose test results along with foodintake and/or medication information. For example, shown in FIG. 10 is adaily graph in which blood glucose level is displayed in the mannerdescribed relative to FIG. 6. Related food intake and medication dosageis indicated directly below contemporaneous blood glucose levels byvertical bar graphs.

[0066] It will be recognized by those skilled in the art that theabove-described screen displays and system operation can readily beattained with conventional programming techniques of the type typicallyused in programming microprocessor arrangements. It also will berecognized by those skilled in the art that various other types ofscreen displays can be generated and, in addition, that numerous otherchanges can be made in the embodiments described herein withoutdeparting from the scope and the spirit of the invention.

[0067] It will also be recognized by those skilled in the art that theinvention can be embodied in forms other than the embodiments describedrelative to FIGS. 1-10. For example, the invention can employ compactvideo game systems that are configured differently than the previouslydiscussed handheld video game systems and palm-top computers. Morespecifically, as is shown in FIG. 11 a self-care health monitoringsystem arranged in accordance with the invention can employ a compactvideo game system of the type that includes one or more controllers 100that are interconnected to a game console 102 via cable 104. As isindicated in FIG. 11, game console 102 is connected to a video monitoror television 106 by means of a cable 108. Although differing inphysical configuration, controller 100, game console 102 and thetelevision or video monitor 106 collectively function in the same manneras the handheld microprocessor 12 of FIG. 1. In that regard, a programcartridge 42 is inserted into a receptacle contained in game console 102with program cartridge 42 including stored program instructions forcontrolling microprocessor circuitry that is located inside game console102. Controller 100 includes a control pad or other device functionallyequivalent to control pad 30 of FIG. 1 and switches that functionallycorrespond to switches 32-38 of FIG. 1.

[0068] Regardless of whether the invention is embodied with a handheldmicroprocessor unit (FIG. 1) or an arrangement such as the compact videogame system (FIG. 11) in some cases it is both possible and advantageousto apportion the signal processing functions and operations differentlythan was described relative to FIGS. 1-10. For example, in somesituations, the microprocessor-based unit that is programmed by a cardor cartridge (e.g., handheld unit 12 of FIG. 1 or compact video gameconsole 102 of FIG. 1) includes memory and signal processing capabilitythat allows the microprocessor to perform all or most of the functionsand operations attributed to data management unit 10 of the embodimentsdiscussed relative to FIGS. 1-10. That is, the digitally encoded signalsupplied by blood glucose monitor 16 (or one of the other monitors 20and 22 of FIG. 1) can be directly coupled to the microprocessor includedin game console 102 of FIG. 11 or handheld microprocessor 12 of FIG. 1.In such an arrangement, the data management unit is a relatively simplesignal interface (e.g., interface unit 110 of FIG. 11) the primarypurpose of which is carrying signals between the blood glucose monitor16 (or other monitor) and the microprocessor of game console 102 (FIG.11) or handheld unit (FIG. 1). In some situations, the interface unitmay consist primarily or entirely of a conventional cable arrangementsuch as a cable for interconnection between RS232 data ports or otherconventional connection arrangements. On the other hand, as is shown inFIG. 11, signal interface 110 can either internally include or beconnected to a modem 52, which receives and transmits signals via atelephone line 50 in the manner described relative to FIGS. 1 and 2.

[0069] It also should be noted that all or a portion of the functionsand operations attributed to data management unit 10 of FIG. 1 can beperformed by microprocessor circuitry located in blood glucose monitor16 (or other monitor that is used with the system). For example, anumber of commercially available blood glucose monitors include aclock/calendar circuit of the type described relative to FIG. 3 and, inaddition, include microprocessor circuitry for generating visual displaysignals and signals representative of both current and past values ofmonitored blood glucose level. Conventional programming and designtechniques can be employed to adapt such commercially available unitsfor the performance of the various functions and operations attributedin the above discussion of FIGS. 1-11 to data management unit 10 and/orthe microprocessors of handheld unit and compact video console 102. Inarrangements in which the blood glucose monitor (or other systemmonitor) includes a microprocessor that is programmed to provide signalprocessing in the above-described manner, the invention can use a signalinterface unit 110 of the above type. That is, depending upon the amountof signal processing effected by the monitoring unit (e.g., bloodglucose monitor 16) and the amount of signal processing performed by themicroprocessor of video game console 102 (or handheld unit the signalinterface required ranges from a conventional cable (e.g.,interconnection of RS232 ports) to an arrangement in which signalinterface 110 is arranged for signal communication with an internal orexternal modem (e.g., modem 52 of FIG. 11) or an arrangement in whichsignal interface provides only a portion of the signal processingdescribed relative to FIGS. 1-10.

[0070] The invention also is capable of transmitting information to aremote location (e.g., clearinghouse 54 and/or a remotely locatedhealthcare professional) by means other than conventional telephonelines. For example, a modem (52 in FIGS. 1 and 11) that is configuredfor use with a cellular telephone system can be employed to transmit thesignals provided by the healthcare monitoring system to a remotelocation via modulated RF transmission. Moreover, the invention can beemployed with various digital networks such as recently developedinteractive voice, video and data systems such as television systems inwhich a television and user interface apparatus is interactively coupledto a remote location via coaxial or fiber optic cable and othertransmission media (indicated in FIG. 11 by cable 112 which is connectedto television or video monitor 106). In such an arrangement, compactvideo game controller 100 and the microprocessor of video game console102 can be programmed to provide the user interface functions requiredfor transmission and reception of signals via the interactive system.Alternatively, the signals provided by video game console 102 (orhandheld unit 12 if FIG. 1) can be supplied to the user interface of theinteractive system (not shown in FIG. 11) in a format that is compatiblewith the interactive system and allows the system user interface to beused to control signal transmission between the healthcare system and aremote facility such as clearinghouse 54, FIGS. 1 and 2.

1. An airflow monitoring system comprising: (a) at least one central server arranged to receive and communicate data; (b) at least one microprocessor-based subsystem (i) including at least one microprocessor, display and memory and (ii) configured to present information on the display and provide a digital signal representative of airflow form a person and (iii) arranged to facilitate communication of airflow-related data to the central server; and (c) at least one health care professional computer in signal communication with the central server to receive health-related information based on the airflow-related data received from the microprocessor-based subsystem.
 2. The system of claim 1, wherein the digital signal is representative of airflow that results when a person expels a breath of air.
 3. The system on claim 2, configured to realize systems for at least one of (a) self-care monitoring and (b) control of afflictions.
 4. The system of claim 3, wherein the affliction is a chronic respiratory affliction.
 5. The system of claim 4, wherein the microprocessor-based subsystem further includes (i) a data management unit; and (ii) a monitoring device that can be received directly by the data management unit or that can be connected to data management unit.
 6. The system of claim 5, wherein at least one monitoring device is (a) configured to monitor at least one person's condition; and (b) connected to facilitate communication of data related to the monitored condition to the central server.
 7. The system of claim 6, wherein at least one monitoring device includes one or more of the set consisting of (a) a blood glucose monitor; (b) a blood pressure monitor; (c) a pulse monitor; and (d) a body temperature monitor.
 8. The system of claim 2, wherein at least one microprocessor, display and memory is in a handheld device.
 9. The system of claim 2, wherein the microprocessor-based subsystem is capable of displaying pictorial information.
 10. The system of claim 2, wherein the microprocessor-based subsystem is capable of displaying animated information.
 11. The system of claim 3, the microprocessor-based subsystem further includes at least one of an insertable program card of cartridge.
 12. The system of claim 11, wherein instructions in the program card or cartridge are configured to facilitate the monitoring.
 13. The system of claim 2, further including at least one personal computer connected for use by the person.
 14. The system of claim 2, wherein the system is configured to use the airflow-related data to process a report
 15. The system of claim 14, wherein the report includes graphs and/or icons.
 16. The system of claim 14, wherein the report includes information for a period of time.
 17. The system of claim 12 wherein the information presented includes at least one message.
 18. The System of claim 17, wherein the message is transmitted to a specific person.
 19. The system of claim 2, wherein the information presented includes step-by-step instructions.
 20. The system of claim 2, wherein the information presented is educational or motivational.
 21. The system of claim 2, wherein the presentation of information can be controlled using at least one menu.
 22. The system of claim 2, wherein the system is configured to enable at least one program to be provided for storage in a memory and execution by the micro-processor-based subsystem.
 23. The system of claim 22, further comprising at least one of an insertable program card or cartridge and wherein at least part of the program is stored on the card or cartridge.
 24. An airflow monitoring method comprising: monitoring airflow from a person by using at least one microprocessor-based subsystem including at least one microprocessor, display and memory; presenting information on the display to the person; producing a digital signal representative of the monitored airflow; communicating airflow-related data to a central server; and providing health-related information, based on airflow-related data communicated to the central server to at least one health care professional.
 25. The method of claim 24, wherein the digital signal is representative of airflow that results when the person expels a breath of air.
 26. The method of claim 25, further comprising at least one of self-care monitoring by the person; and controlling an affliction of the person.
 27. The method of claim 26, wherein the affliction is a chronic respiratory affliction.
 28. The method of claim 27, wherein the microprocessor-based subsystem further includes (i) a data management unit; and (ii) a monitoring device that can be received directly by the data management unit or that can be connected to data management unit.
 29. The method of claim 28, further comprising: monitoring at least one person condition with at least one monitoring device; and communicating data related to the monitored condition for delivery to the central server.
 30. The method of claim 29, wherein the monitored condition includes one or more of the set consisting of (a) blood glucose; (b) blood pressure; (c) pulse; and (d) body temperature.
 31. The method of claim 25, wherein at least one microprocessor, display and memory is in a handheld device.
 32. The method of claim 25, further comprising displaying pictorial information on at least one of the displays.
 33. The method of claim 25, further comprising displaying animated information on the display.
 34. The method of claim 26, further comprising using instructions in a program cartridge or card to facilitate the monitoring.
 35. The method of claim 25, further comprising connecting at least one personal computer for use by the person.
 36. The method of claim 25, further comprising using the airflow-related data to process a report.
 37. The method of claim 36, wherein the report includes graphs and/or icons.
 38. The method of claim 36, wherein the report includes information for a period of time.
 39. The method of claim 25, wherein the presented information includes at least one message.
 40. The method of claim 39, wherein the message is for a specific person.
 41. The method of claim 25, wherein the presented information includes step-by-step instructions.
 42. The method of claim 25, wherein the presented information is educational or motivational.
 43. The method of claim 25, further comprising controlling the presentation of information by using at least one menu.
 44. The method of claim 25, further comprising providing at least one program; storing the program; and executing the stored program with the microprocessor-based subsystem.
 45. The method of claim 44, wherein at least part of the provided program is on an insertable card or cartridge.
 46. A microprocessor-based apparatus for monitoring airflow, comprising: (a) at least one microprocessor, display and memory, (b) the memory being readable by the microprocessor and embodying program instructions executable by at least one microprocessor to (i) cause information to be presented on the display, (ii) process digital signals representative of airflow from a person; and (iii) to facilitate communication of airflow-related data to a central server.
 47. The apparatus of claim 46, wherein the digital signal is representative of airflow that results when a person expels a breath of air.
 48. The apparatus of claim 47, configured to realize systems for at least one of self-care monitoring and control of afflictions and physical conditions.
 49. The apparatus of claim 48, wherein the affliction is a chronic respiratory affliction.
 50. The apparatus of claim 49, further comprising (i) a data management unit; and (ii) a monitoring device that can be received directly by the data management unit or that can be connected to data management unit.
 51. The apparatus of claim 50, wherein at least one monitoring device is configured (a) to monitor at least one person condition; and (b) to facilitate communication of data related to the monitored condition to the central server.
 52. The apparatus of claim 51, wherein at least one monitoring device includes one or more of the set consisting of: (a) a blood glucose monitor; (b) a blood pressure monitor; (c) a pulse monitor; and (d) a body temperature monitor.
 53. The apparatus of claim 47, wherein at least one microprocessor, display and memory is in a handheld device.
 54. The apparatus of claim 47, wherein the microprocessor-based apparatus is capable of displaying pictorial information.
 55. The apparatus of claim 47, wherein the microprocessor-based apparatus is capable of displaying animated information.
 56. The apparatus of claim 48, the microprocessor-based apparatus further includes at one of an insertable program card or cartridge.
 57. The apparatus of claim 56, wherein instructions in the program card or cartridge are configured to facilitate the monitoring
 58. The apparatus of claim 47, wherein the microprocessor-based apparatus is configured to use to display a report.
 59. The apparatus of claim 58, wherein the report includes graphs and/or icons.
 60. The apparatus of claim 58, wherein the report includes information for a period of time.
 61. The apparatus of claim 48, wherein the information presented includes at least one message.
 62. The apparatus of claim 48, wherein the information presented includes step-by-step instructions.
 63. The apparatus of claim 48, wherein the information displayed is educational or motivational.
 64. The apparatus of claim 48, wherein the display of information can be controlled using at least one menu.
 65. The apparatus of claim 48, wherein the microprocessor-based apparatus is configured to receive at least one program and execute the program.
 66. The apparatus of claim 65, wherein at least part of the program is stored on an insertable card or cartridge.
 67. A microprocessor-based apparatus for airflow monitoring, comprising (a) at least one microprocessor; (b) display; (c) a first memory in the form of an insertable program card or a cartridge; and (d) at least a second memory, the first and second memories embodying program instructions executable by at least one microprocessor to (i) cause information to be presented on the display, (ii) process digital signals representative of airflow from a person; and (iii) to facilitate communication of airflow-related data to a remotely located computer.
 68. The apparatus of claim 67, configured to realize systems for at least one of (a) self-care monitoring, and (b) control of afflictions.
 69. The apparatus of claim 67, wherein the affliction is a chronic respiratory affliction.
 70. The apparatus of claim 69, further comprising a monitoring device is configured (a) to monitor at least one person condition; and (b) to facilitate communication of data related to the monitored condition to the central server
 71. The apparatus of claim 70, wherein at least one monitoring device includes one or more of the set consisting of (a) a blood glucose monitor; (b) a blood pressure monitor; (c) a pulse monitor; and (d) a body temperature monitor.
 72. The apparatus of claim 67, wherein at least one microprocessor, display and memory is in a handheld device.
 73. The apparatus of claim 67, wherein the microprocessor-based apparatus is capable of displaying pictorial information.
 74. The apparatus of claim 67, wherein the microprocessor-based apparatus is capable of displaying animated information.
 75. The apparatus of claim 67, wherein the microprocessor-based apparatus is configured to display a report.
 76. The apparatus of claim 75, wherein the report includes graphs and/or icons.
 77. The apparatus of claim 75, wherein the report includes information for a period of time.
 78. The apparatus of claim 68, wherein the information presented includes at least one message.
 79. The apparatus of claim 68, wherein the information presented includes step-by-step instructions.
 80. The apparatus of claim 68, wherein the information presented is educational or motivational.
 81. The apparatus of claim 68, wherein the display of information can be controlled using at least one menu.
 82. The apparatus of claim 68, wherein the microprocessor-based apparatus is configured to receive at least one program and execute the program. 